Senior Care Records.

Facility Evaluation Report

Providence Adult Residential Home, INC., Santa Maria04/17/2025Licence 425850606

Capacity4
Census4
Date signed04/17/2025 11:12:15 AM
Name of licensing program analystMark Jeffries
Name of licensing program managerKelly Burley
The inspector’s account

At 9:30am on 04/17/2025, Licensing Program Analyst (LPA) Jeffries conducted a scheduled pre-licensing visit to meet with Licensees Analiza Jemerson and Hector Mariscal.

LPA toured the facility with Licensees. The facility is a one story house with 4 client bedrooms, staff bedroom with staff bathroom, 1 bathroom for clients, kitchen, dining room, living room, office and garage. The property is fenced from the backyard. There are shaded patio areas with seating for residents to use. Smoke alarms and carbon monoxide detectors are functioning. Fire extinguishers are fully charged. The facility is clean and in good repair, including floors and walls. Windows, screens, and curtains/blinds are in good condition. All walkways are free of obstruction. The facility maintains a comfortable temperature of around 70 degrees. Hot water temperature was measured at within regulation temperatures 105-120*(f). Cleaning solutions and other hazards are inaccessible to residents and locked. There is an adequate supply of linen and towels for all residents. Food storage and prep areas are clean and there is an adequate supply of dishes, glasses and utensils. The freezer and refrigerator are at proper temperature range. There is an adequate amount of emergency food. The facility has an updated disaster and mass casualty plan. First aid kit present and complete. Medications will be kept in a locked cabinet in the locked facility office. Resident and staff files are available. Laundry equipment, telephones, emergency lighting are present. The facility has a sufficient amount of activity supplies and sufficient space for indoor and outdoor activities.

Exit interview, report provided. A copy of this report will be forwarded to the Centralized Application Bureau.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction